How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3.24 Median $7.94 Typical High $16.60 | Facility | None | $3.24 | $7.94 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.89 | Professional | None | $2.88 | $2.88 | $3.89 |
Ambetter Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.47 Median $7.59 Typical High $20.89 | Facility | None | $3.47 | $7.59 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.27 | Professional | None | $2.88 | $2.88 | $4.27 |
Aultcare Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Aultcare Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
CareSource Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
CareSource Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.07 | Professional | None | $3.16 | $3.16 | $4.07 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $6.17 Typical High $9.55 | Facility | None | $5.50 | $6.17 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.63 | Professional | None | $2.88 | $2.88 | $3.63 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $6.17 Median $7.59 Typical High $19.95 | Facility | None | $6.17 | $7.59 | $19.95 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $8.51 | Professional | None | $2.88 | $2.88 | $8.51 |
Molina Setting Professional Modifier None Typical Low $2.88 Median $3.55 Typical High $4.47 | Professional | None | $2.88 | $3.55 | $4.47 |
SummaCare Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $3.55 | Professional | None | $2.88 | $3.02 | $3.55 |
United Setting Professional Modifier None Typical Low $2.82 Median $3.24 Typical High $4.17 | Professional | None | $2.82 | $3.24 | $4.17 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.45 Median $1.45 Typical High $1.66 | Professional | 52 · Reduced service | $1.45 | $1.45 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.58 Typical High $0.68 | Professional | 53 · Discontinued | $0.58 | $0.58 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.43 Median $0.43 Typical High $0.50 | Professional | 55 · Aftercare only | $0.43 | $0.43 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.34 |
Ambetter Setting Professional Modifier JZ · No drug discarded Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | JZ · No drug discarded | $4.57 | $4.57 | $4.57 |
Where Ohio sits
The same service costs 3.1 times more in Wyoming than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Ohio· 46th of 51
$2.88
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.